Medical-surgical Nursing Demystified

(Sean Pound) #1

(^148) Medical-Surgical Nursing Demystified
PROGNOSIS
Prognosis may be guarded, depending on how severe the reaction is and how quickly
treatment is rendered. Patients need to be monitored for 1 to 2 days after treatment
and cautioned about reexposure to the offending item.
HALLMARK SIGNS AND SYMPTOMS



  • Shortness of breath due to swelling of the larynx

  • Hypotension and shock due to generalized vasodilation

  • Sneezing—a common occurrence to an allergan

  • Anxiety secondary to difficulty in breathing

  • Rales (crackles) heard in the lungs—due to fluid in the lungs

  • Wheezing (rhonchi) due to bronchospasm


INTERPRETING TEST RESULTS


Tryptase levels are from mast cells which increase in anaphylaxis. After the acute
episode is over, allergy skin testing is recommended.

TREATMENT



  • Administer emergency medications:

    • epinephrine to open airways and to reduce bronchospasm

    • corticosteroids to reduce symptoms

    • antihistamines to mitigate symptoms



  • Administer circulatory volume expanders to treat hypotension caused by
    vasodilation:

    • saline

    • plasma

    • IV fluids



  • Administer vasopressors to counteract vasodilation and to increase blood
    pressure:

    • norepinephrine

    • dopamine



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